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Surely the lesson here is that we should be trying to influence protocols before the testing occurs, rather than trying to comment on numbers and tests where minimal relevant clinical information is available? My commonest comment is along the lines of "ring me" dj From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mohammad Al-Jubouri Sent: 22 November 2012 15:48 To: [log in to unmask] Subject: Infertility hormonal assessment Many thanks for the many replies I have received so far, most of you correctly identified the possibilty of pregnancy and asked for Beta-hCG result which was 270 IU/L confirming very early pregnancy. One colleague said he would put a comment "congratulations she is pregnant now"; though I wouldn't say congratulations yet as this is very early pregnancy and may be even occult ending by the next period. Incidentally this pm, there was another hormonal profile on a very young lady with irregular periods from a GP via order comm, this showed: FSH <0.1 LH <0.1 Oestradiol >11010 Progesterone 183 Prolactin 3266 Testosterone 2.3 Beta-hCG awaiting Even if I am confident that she is well into her pregnancy, I wouldn't say congratulations as it could be an unwanted pregnancy. So is this sort of request excessive? it all depends on the clinical situation they are investigating, for example in the first instance if they were only assessing luteal function/ovulation then requesting day 21 progesterone is sufficient. While in the second case they are investigating possible PCO, so the request is justified. Regards Mohammad From: Mohammad Al-Jubouri <[log in to unmask]<mailto:[log in to unmask]>> To: [log in to unmask]<mailto:[log in to unmask]> Sent: Thursday, November 22, 2012 12:02 PM Subject: Infertility hormonal assessment A GP requested the following hormones on a young female patient with a clinical detail of "infertility"; the request came via the GP order comm system and the results were as follows: FSH 1.3 mU/L LH 0.5 mU/L Oestradiol 938 nmol/L Progesterone 71 nmol/L Prolactin 480 mU/L What would be your comment? would you consider this as excessive requesting? Regards Mohammad Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath Consultant Chemical Pathologist ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk/ Green Laboratories Work http://www.laboratorymedicine.nhs.uk/ List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail in error and delete this e-mail from your system. If you are not the intended recipient you are notified that disclosing, copying, distributing or taking any action in reliance on the contents of this information is strictly prohibited. ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/